Major Incident Plan

Major Incident Plan Reference Number : NHSCT/09/199 Responsible Directorate : Acute Hospital Services Replaces (if appropriate): Legacy Causeway Trust Hospital and United Hospital - Major Incident Plan Policy Author/Team : Type of document : Elaine Coulter Corporate Plan General Manager – Acute Operational Support/ Eugene Hagan Emergency Planning Co-Ordinator Approved by : Date Policy disseminated by Equality Unit : Governance Management Board 28 September 2009 Date Approved : 1 September 2009 NHSCT MISSION STATEMENT To provide for all the quality of services we would expect for our families and ourselves Major Incident Plan Approved Sept 2009 This is a controlled document and must not be photocopied without permission of the Director with Portfolio for Emergency and Business Continuity Planning 1 Contents Page No Introduction to Emergency Planning & Roles/Responsibilities of Organisations 4 – 8 Objectives of The Major Incident Plan 9 Activation of The Major Incident Plan 10 Alert Procedure/Response (Hospital/Community) 11-13 Control and Information Team (CIT) - Hospital Major Incident 14 Location of Control & Information Teams 15 Major Incident in the Community 16 Northern Health and Social Care Trust (Silver Command) 17 Briefing/Debriefing/Care of Staff 18 - 19 General Roles/Responsibilities 20 - 36 Section 1 Chief Incident Control Officer 20 Section 2 NIAS 22 Section 3 Telephonist 23 - 24 Section 4 Emergency Department Sister 25 Section 5 Emergency Department Consultant 26 Section 6 Nursing Incident Officer 27 Section 7 Patient Flow Co-ordinator 28 Section 8 Services/Information Manager 29 - 30 Section 9 Radiography Department 31 Section 10 Portering Services 32 Section 11 Corporate Communications 33 Section 12 Hospital Social Work Service 34 Section 13 Pathology 35 Section 14 Stand down 36 2 APPENDICES Page No 1 Control and Information Team (CIT) Membership 37 - 39 2 Telephonist 40 - 42 3 INTRODUCTION The Northern Health and Social Care Trust became operational on 1 April 2007. It provides services to the areas formerly covered by Homefirst, Causeway and United Hospitals Trusts. The Trust is geographically the largest in Northern Ireland and employs approximately 14,000 staff providing services to a population of around 440,000 both rural and suburban communities. The Trust provides a comprehensive range of hospital and community based health and personal social services. It is coterminous with 10 local council areas (Ballymoney, Coleraine, Moyle, Antrim, Ballymena, Magherafelt, Cookstown, Larne, Carrickfergus and Newtownabbey), and 4 PSNI Districts (H, D, G & F). 4 Introduction to Emergency Planning Within the Northern Ireland Civil Contingencies Framework, (NICCF) November 2005, based upon the Civil Contingencies Act 2004 introduced to the UK, is a set of guiding principles and “is primarily about what organisations should do rather than how they should do it”. The then Secretary of State for NI, Peter Hain MP, stated that he “expects NI to attain the same standards of protection, preparedness and response as exists elsewhere in the UK”. The framework sets standards, and for certain organisations, Police Service of Northern Ireland and Maritime Coastguard Agency, it has a statutory basis. However, it is implicit in the document that Health and Social Services Trusts are expected to maintain a level of civil contingencies preparedness as is commensurate with its roles and responsibilities, as it applies to emergency planning response. By ‘civil contingencies’ we mean… “Events and situations impacting on the community which may or may not occur, but would lead to an emergency if it did…. and covers all the hazards and threats that could impact upon human welfare, the environment …. And are the activities undertaken by individuals and organisations to prevent emergencies and critical business interruptions to mitigate and control their effects and to prepare and respond …” (NI Civil Contingencies Framework Chapter 2). The document introduces core principles which place a number of responsibilities on organisations, to ensure that civil contingency activities become part of normal business planning activities, including risk assessment, development and maintenance of plans, organisational preparedness and response to a declared emergency. It also details guiding principles, established by the UK Group, on how we should implement these duties. The document ‘A Guide to Emergency Planning Arrangements in N Ireland (July 2004 CEPU/OFMDFM) sets out …”a framework to assist organisations to manage and co-ordinate their civil protection activities”. Section 5.23 clarifies the responsibilities of Health and Social Services Trusts -: Co-ordination of health services Provision of appropriate immediate, medium and Long-term in-patient and community care for those affected by emergencies Welfare services including provision of Rest Centre Accommodation Provision of resources for planning, training and response and In conjunction with the N Ireland Ambulance Service …provision of emergency response from mobile medical teams and E&D departments of hospitals (Section 5.8) and in (Section 5.2) With the Police Service of Northern Ireland it commits the Trust to assisting the police in evacuation procedures. 5 There is also a need for the Trust to liaise with other organisations or agencies to ensure a multi-agency response. We are reminded that …”no single organisational arrangement will be appropriate to each and every type of major incident” [(1.7) Dealing with Disaster Revised 3 rd edition (Cabinet Office)]. And that …”inter organisational management and co-ordination to ensure organisations work together in a controlled and coherent way in order to meet the immediate, medium and long-term needs”… is needed (Guide to Emergency Planning Arrangements in Northern Ireland July 2004). “Organisations should work both individually and in collaboration with each other on certain key issues” (Dealing with Disaster; Revised 3 rd edition (2.1). This concept of working together is known as Integrated Emergency Management (IEM). Hence the Trust in addressing issues under the broad heading of emergency planning should look for …”mutual aid arrangements with parallel organisations …within the planning process” (2.7, Dealing with Disaster Revised 3 rd edition Cabinet Office). Integrated Emergency Management Emergency Services and Health and Social Care Trusts involved in the response to a major emergency need to co-operate effectively, hence close collaboration at the planning, exercise and response stage are essential. Also important is understanding of the role and remit of such partner agencies to ensure a truly integrated emergency management approach. In the majority of situations the Trust will not have personnel at the scene of the incident, the organisations present there will be Police Service of Northern Ireland (PSNI), Northern Ireland Fire & Rescue (NIFR), and Northern Ireland Ambulance Service (NIAS). Main Responsibilities of these agencies are: Police Service of Northern Ireland (PSNI) • Security of the scene • Documentation procedure if required • Identification and reuniting of family members • Criminal investigation • Body recovery • Act as a representative of the Coroner’s office Northern Ireland Fire & Rescue Service (NIFRS) • Put out a fire • Search and rescue • Decontamination of the area and affected individuals • Establish safe working area Northern Ireland Ambulance Service (NIAS) • Provision of First Aid, Nursing & Medical Services • Patient assessment & Observation • Provision of Ambulance Transport 6 During a major incident it is the responsibility of the NIAS to decide which hospital will be designated to receive patients. Not all hospitals will receive seriously injured patients, some may receive less seriously injured patients or following negotiations admit patients decanted from a receiving hospital. Acute Hospitals Provision of Hospital Emergency Services to injured persons and any subsequent medical treatment required. An alert procedure initiated by NIAS will be triggered should a ‘Trust Acute Hospital’ be designated as a receiving hospital. Should such an event occur, the hospital will decide if it needs to initiate its Major Incident Plan or if it can manage to deal with the matter as “per normal business.” If the latter is the case the hospital may decide to initiate its own Business Continuity Management (BCM) plan to cope with the influx of patients. Community Management/staffing of Emergency Support Centres Designated Trust staff known as the Emergency Response Team are the first responders to a major incident happening in the community where an Emergency Support Centre has been established. Responsibility within such a Centre includes • Management of Emergency Support Centre including registration & provision of meals • General Welfare of persons • Provision of psychological support and advice at Emergency Support Centre • Post event, provide a short term follow up service, if appropriate, to survivors and their families and to family members of deceased persons. • Management of Relatives & Friends Centre (if opened) See Section Major Incident in the Community Page 16. A separate multi-agency protocol “Emergency Support Centre Provision“ sets out explicitly the roles/responsibilities of the various agencies in attendance at an Emergency Support Centre”. Agencies include NHSCT, PSNI, NIAS, Local Councils/owners of buildings (or a Representative organisation, British Red Cross/St John’s/Knight of Malta).

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